The Challenges of Assessing Osteoarthritis and Postoperative Pain in Dogs

Abstract

Abstract. The challenge of measuring pain in veterinary medicine is compounded by the lack of fully validated, reliable methods to measure and assess pain in nonverbal patients. In human medicine, there are numerous, validated pain assessment tools (PATs) for assessing various, specific types of pain. The advances in human medicine pain management and numerous validated pain scales should serve as incentives and templates to facilitate similar advances in the development of validated PATs for use in dogs (and other species). The limited number of canine PATs constrains our ability to adequately and reliably assess pain. Improving the ability to quantify osteoarthritis and postoperative pain in dogs would enhance the development of analgesics for animals, advance the management of animal pain, facilitate the use of animal pain models in preclinical trials for human analgesics, and provide insight into the quantification of pain responses in humans who lack the ability to adequately communicate. This review describes the need for practical, valid, and reliable PATs for use in veterinary patients and discusses some currently available PATs commonly used to evaluate acute and chronic pain in dogs.

Feasibility and repeatability of cold and mechanical quantitative sensory testing in normal dogs

“…As such, assessment of acute and chronic pain is vital, yet challenging. In veterinary medicine, our ability to accurately and reliably assess pain is limited by the lack of quantitative and thoroughly validated tools for its measurement (Sharkey, 2013). Furthermore, chronic pain, such as that associated with osteoarthritis (OA), can be complicated by long-term changes in dorsal horn neurons, resulting in central sensitization (CS) and ‘pathologic pain’ (Woolf, 2007; Gwilym et al, 2009; Graven-Nielsen and Arendt-Nielsen, 2010).…”

Questionnaire‐based Analysis of Owner‐reported Scratching and Pain Signs in Cavalier King Charles Spaniels Screened for Chiari‐like Malformation and Syringomyelia

“…It is crucial to have quantitative measures of chronic pain that are valid and reliable in clinical patients to enable development and testing of interventions (such as drugs or surgical procedures) designed to decrease such pain. Given the importance of owner observations in describing and quantifying pain in their pets, and the growing interest in identifying and treating neuropathic pain in dogs, there is a need to better understand how to identify and quantify this pain using owner assessments. Limited data are available on the utility of owner questionnaires for this condition, and none of the available questionnaires have been developed after recognized psychometric approaches .…”

Systematic Review of Outcome Measures Reported in Clinical Canine Osteoarthritis Research

“…This is not surprising, as lameness and pain are likely to be of importance to owners and radiography is one of the few objective assessments available to veterinarians assessing these dogs in first‐opinion practice. A recent narrative review of some of the outcome measures used in canine OA highlighted that no single outcome truly captures the complexity of this disease . This complexity likely explains, at least in part, the multitude of different outcomes that are assessed and reinforces that more work is needed to determine which outcomes best reflect relevant clinical change.…”

“…It is hoped that these recommendations, in combination with reporting guidelines, will help veterinary researchers and editors improve the quality of future publications. Simple interventions such as enforced, standardized reporting of force plate gait analysis methodology would help enable comparisons to be made between results of studies that use this methodology across all fields of veterinary orthopedics …”